Wendi C. Thomas: Mentally ill slowly finding help, acceptance

Hawkins is one of many of the city's mentally ill who find help at Door of Hope. Director Dr. June Averyt estimates about 75 percent of her guests have a mental illness. And she's convinced there's no way for a person to get clean, sober and sane on the street. The mental health system allows people to fall through the cracks, says Averyt. "All I deal with are the cracks."

Michael Hawkins, 31, paces a hallway while waiting for coordinator Dr. June Averyt to give him a new pack of cigarettes at the Door of Hope after lunch. The home is at 245 N. Bellevue, and is a place for the homeless and mentally ill. Hawkins is a schizophrenic who is off his medication.

Mental illness can be an irregular visitor, such as with Debra Brittenum's daughter Jeannette, 40, who committed suicide in October after a bout with depression.

Or mental illness can be a constant companion, as it was for Jonathan Haines, 24. His parents watched their son battle eight psychiatric diagnoses before he took his life in July 2008.

Mental illness can be a small part of a person's whole, as is the case with Brad Cobb and Sandra Armstrong, who work with the mentally ill and their families every day.

For those with no support, such as Michael Hawkins, mental illness can be a haze that traps them in life's shadows.

Hawkins, 31, is a regular guest at Door of Hope, a safe place for the homeless and/or those with mental illnesses.

Diagnosed with schizophrenia, Hawkins talked a lot but said little.

"Word salad," explained Dr. June Averyt, director of Door of Hope, of the language patterns common to those with schizophrenia.

What mental illness isn't, though, is well-understood or accommodated in society.

"When people don't understand, they tend to fear and ... avoid people who have mental illness," said Dr. James Greene, professor and chair of psychiatry at UT Health Sciences Center.

But over the last several years, the options for pharmaceutical help for mental illness has expanded, and movies such as "One Flew Over the Cuckoo's Nest" have given way to movies depicting those with mental illness with more compassion, such as "A Beautiful Mind" and "The Soloist."

"The public is beginning to understand much more than they did," Greene said. "Those biases are slowly moving away."

Still, a fading shroud of stigma and shame remains. Those with mental illnesses often go overlooked by those uninformed about the disease and uncomfortable with its unpredictability.

If you have a psychiatric diagnosis and live in Memphis, the quality of your life depends greatly on if you have health insurance and a supportive, assertive family and/or advocates with resources to fill in where insurance does not.

If you don't, it's a quick trip to the bottom.

Without a safety net, the mentally ill can often be found disheveled and dirty, toting their life in bags, mumbling to themselves. Often they are without the medication and/or therapy that could reshape their lives -- and just beyond the grasp of social service agencies that could guide them to the few programs designed to help.

Praying for healing

For its mental health care system, the National Alliance on Mental Illness last gave Tennessee a grade of D.

Still, Memphis is cited as a national model for jail diversion for the mentally ill and the Memphis Police Department's Crisis Intervention Team, in which specially trained officers go to the scene of calls in which a mentally ill person is involved.

Mark and Nina Haines weren't concerned with the state's grades when their youngest son, Jonathan was diagnosed as a child with attention deficit disorder and ultimately seven other diagnoses.

As a teenager, Jon was on and off 14 different medicines as doctors tried to come up with the right concoction. Jon was in and out of different treatment programs that nearly bankrupted the family, but he still managed to graduate from Germantown High and ITT Tech.

The Haines family turned to their faith, and Jon became a Christian. All along, his parents had been praying for his healing, pained to see their son go through repeated psychotic breaks.

"The ultimate healing is healing when God takes him home through physical death. ... I knew that," Nina Haines said.

His last diagnosis was schizo-affective disorder. He said voices were telling him to do bad things and doctors had told him to expect psychotic breaks every three to five years.

"He desired to be normal," said Nina Haines, who for her doctoral dissertation in divinity school is writing a book about her son's ordeal and how her faith sustained her and her husband.

But Jon wasn't normal. And, Nina Haines suspects, after years of living well, he began to feel another break coming. He shot himself in the apartment where he lived, above his parents' garage in July 2008.

The pain, the Haines said, never goes away, and the silence that surrounds mental illness is not the salve some may think it is.

"It's made fun of on TV, families tend to be ashamed of it for whatever reason, people at church don't talk about it ... although it's just another illness," said Mark Haines, an electrical contractor.

"How many people do you know with diabetes?" Mark Haines asked, "But when it come to depression ..." He puts his hand over his mouth.

When Jeannette Lee Brittenum Fields hung herself in October in her Washington, D.C. home, her mother, Debra Brittenum, knew one thing for sure.

Brittenum would tell the truth about how her Memphis-bred child had lived and died.

At the memorial service at First Congregational Church, Rev. Sonia Walker eulogized Jeannette as a teacher, a partner, a mother.

She was just another who just couldn't wait on God's timing, much like Abraham and Sarah couldn't wait on God's timing for a child, or the prodigal son couldn't wait on his inheritance.

And in an interview weeks after her daughter's death, Brittenum recalls how her entire life, it seems, had been preparing her for her daughter's death.

Brittenum, a lawyer by training, worked at Memphis Area Legal Services. Her speciality: protecting the rights of those with psychiatric diagnoses.

In her home, as her daughter Jeannette began to grow up, Brittenum didn't see many signs of distress.

When Jeannette came out as a lesbian, Brittenum noticed she seemed agitated, but thought her daughter's worry was simply about the family's reaction, which was supportive.

And at one point, Jeannette had been homeless for a few weeks in Atlanta, after she left Spelman College. She returned to Memphis and graduated from the University of Memphis.

When Jeannette moved to Washington in 2000, she was briefly hospitalized with depression.

A year before she died, surgery for fibroid tumors sent her into menopause at 39.

"I never thought Jeannette would not have a functional adjustment to anything," Brittenum said. "It's just a warning to all of us."

Yes, a mother trained to spot signs of mental anguish in others missed the signs in her daughter.

Jeannette, an avid tennis player, had surgery on both her knees and was inactive all summer. She developed a dependency on the pain medication and went into a treatment facility to detox over a weekend.

When she returned to the school where she taught math to students with special needs, Jeannette was told she would also be teaching reading and science -- subjects Jeannette didn't feel prepared teach.

She told her supervisor that she was struggling, that she was suffering from depression -- and the supervisor told her she could always resign.

Flustered and frustrated, Jeannette did.

But when she called back hours later asking to retract her resignation, her supervisor refused.

"This is the justice issue," Brittenum said, her anger peeking through her grief.

Jeannette had resigned on Sept. 25 and by Oct. 8, she was dead.

"Maybe legally (the school) had the right to do this, but it was not moral or just."

Now, Brittenum is on a mission to expand the definition of what's socially appropriate to include people with, as Brittenum prefers to call it, psychiatric diagnosis.

"It's up to us who don't have limiting factors to figure out," Brittenum said -- how to make a comfortable space for those who do wrestle with mental illnesses.

Falling through the cracks

One of the many in Memphis who reach out to the mentally ill and/or homeless (the two often overlap) is Door of Hope's June Averyt.

A group has found refuge this cold day in the Midtown home, and Averyt warned them of an impending police round-up of the homeless Downtown.

Then she shared the news about Vincent Dunlap, a client of the agency, whose mental illness prevented him from understanding the importance of seeking life-saving dialysis.

Fighting back tears, Averyt said Dunlap had been found dead days before, in his apartment.

He had been diagnosed with schizo-affective disorder, and jailed for throwing a rock through a church window. In jail, he got dialysis. Out of jail, he got drunk.

She estimates that 75 percent of her guests also have a mental illness.

And she's convinced that there's no way to get clean, sober and sane on the streets, which is why she puts so much emphasis into getting people into rooming houses, apartments or the few rooms in Door of Hope.

"Our culture doesn't allow nakedness, but we allow homelessness," said Averyt, beginning to bristle at the system's flaws.

The mental health system, she says, allows people to fall through the cracks.

Said Averyt: "All I deal with are the cracks."

A place without shame

Before mental health consumers fall through the cracks, their families often reach out to the Memphis chapter of National Alliance on Mental Illness, where Brad Cobb and Sandra Armstrong help people to live well with their illnesses.

Cobb, NAMI Memphis' executive director, and Armstrong, a VISTA volunteer, are not only advocates, they're both mental health consumers and have family with mental illnesses.

Cobb has battled clinical depression for years; Armstrong also has depression and anxiety disorders.

Armstrong's sister has paranoid schizophrenia and Cobb, then at the sheriff's department, was introduced to NAMI because of his daughter, who has bipolar disorder.

By the time Cobb's daughter was 12, she had exhausted her lifetime health insurance cap of $1 million. She's been hospitalized 37 times since she was 5.

"It's sad to say, but I had given up hope," Cobb admitted over lunch.

But today, Cobb said, "she is very much into her recovery," is married and has two children.

NAMI's support groups, Cobb said, were life-changing, even though his wife had to drag him there. "It was the first time you could take the coat of shame off."

The nonprofit organization offers free and confidential support groups for mental health consumers and their families, and helps consumers tell their stories, in their own words.

"The safety net," he said, "is all but gone," particularly for those who don't have insurance.

"I don't know the answers ... but I know that something's going to change."

Tearing down the barriers

In at least one key area, some things have changed.

Memphis can proudly tout this: It is a national model for keeping the mentally ill out of jail and, instead, getting them into recovery.

It's called the Jericho Project and officially, it's the county's post-booking diversion strategy for persons with serious mental illness and substance abuse.

Which is a laborious way to say that people with mental illness and addictions don't belong in the jail, explained Stephen Bush of the Shelby County Public Defender's Office.

Jericho draws its name from the Biblical city where the people marched around the city's walls until they fell down. And the Jericho Project too, tears down the barriers between the mentally ill and their recovery.

As soon as a judge signs off on a tailored recovery plan in lieu of jail for a person with a mental illness, he or she is paired immediately with a recovery support specialist who meets the client at the back door of the jail.

Those specialists are navigators who do for the mentally ill what they are unlikely to be able to do for themselves -- wading through the acronym soup and maze of agencies to get Social Security benefits, Tenncare if needed, into inpatient or outpatient treatment, into housing, to help them get and stay on their medication.

Bush has been with the Jericho Project since its beginning and is now working on the Jericho Initiative, which would extend these best practices to other marginalized jail populations, including those with HIV/AIDS.

It's a tight web of alliances between county, local and federal government, community resources, but it works.

Slowly but surely, the criminalization of mental illness is ending in Shelby County, Bush said, as it should, and the benefits to public safety and public health are quantifiable.

All because, Bush points out, it was decided that yes, we could and would care for "the least of these."